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From Pressure to Practice: Institutional Pressures and ESG Adoption in LMIC Healthcare- A Case Study of Ghanaian Public Hospitals

Abdulai, Sualihu Wunniche LU and Im, Yujin LU (2025) SMMM40 20251
Department of Service Studies
Abstract
This study explores the integration of Environmental, Social, and Governance (ESG) frameworks within public hospitals in Ghana, focusing on the institutional pressures influencing ESG adoption and their impact on healthcare professionals’ daily operations. It also considers the alignment of these practices with selected United Nations Sustainable Development Goals (SDGs). Addressing gaps in the literature—such as the dominance of high-income country perspectives, the limited voices of internal stakeholders, and overreliance on
quantitative methods—this research adopts a qualitative approach grounded in institutional theory. Drawing on semi-structured interviews with 14 clinical and non-clinical staff at two district public hospitals in... (More)
This study explores the integration of Environmental, Social, and Governance (ESG) frameworks within public hospitals in Ghana, focusing on the institutional pressures influencing ESG adoption and their impact on healthcare professionals’ daily operations. It also considers the alignment of these practices with selected United Nations Sustainable Development Goals (SDGs). Addressing gaps in the literature—such as the dominance of high-income country perspectives, the limited voices of internal stakeholders, and overreliance on
quantitative methods—this research adopts a qualitative approach grounded in institutional theory. Drawing on semi-structured interviews with 14 clinical and non-clinical staff at two district public hospitals in Ghana, the study investigates how ESG principles are interpreted and enacted in under-resourced settings. The findings show that institutional pressures—coercive, normative, and mimetic—shape ESG adoption in uneven ways. Practices are often
informal, fragmented, and initiated by individuals rather than formal strategies. Environmental initiatives are most visible but lack strategic direction; social efforts face weak institutional support; and governance practices are hindered by leadership and accountability gaps. This
Research contributes to ESG discourse by situating sustainability within the lived experiences of LMIC healthcare professionals. It offers theoretical insight into how institutional pressures function in resource-limited environments and provides practical guidance for developing context-sensitive ESG strategies in public hospitals. (Less)
Popular Abstract
This study explores the integration of Environmental, Social, and Governance (ESG) frameworks within public hospitals in Ghana, focusing on the institutional pressures influencing ESG adoption and their impact on healthcare professionals’ daily operations. It also considers the alignment of these practices with selected United Nations Sustainable Development Goals (SDGs). Addressing gaps in the literature—such as the dominance of high-income
country perspectives, the limited voices of internal stakeholders, and overreliance on quantitative methods—this research adopts a qualitative approach grounded in institutional theory. Drawing on semi-structured interviews with 14 clinical and non-clinical staff at two
district public hospitals in... (More)
This study explores the integration of Environmental, Social, and Governance (ESG) frameworks within public hospitals in Ghana, focusing on the institutional pressures influencing ESG adoption and their impact on healthcare professionals’ daily operations. It also considers the alignment of these practices with selected United Nations Sustainable Development Goals (SDGs). Addressing gaps in the literature—such as the dominance of high-income
country perspectives, the limited voices of internal stakeholders, and overreliance on quantitative methods—this research adopts a qualitative approach grounded in institutional theory. Drawing on semi-structured interviews with 14 clinical and non-clinical staff at two
district public hospitals in Ghana, the study investigates how ESG principles are interpreted and enacted in under-resourced settings. The findings show that institutional pressures—coercive, normative, and mimetic—shape ESG adoption in uneven ways. Practices are often informal, fragmented, and initiated by individuals rather than formal strategies. Environmental initiatives are most visible but lack strategic direction; social efforts face weak institutional support; and governance practices are hindered by leadership and accountability gaps. This research contributes to ESG discourse by situating sustainability within the lived experiences of LMIC healthcare professionals. It offers theoretical insight into how institutional pressures function in resource-limited environments and provides practical guidance for developing context-sensitive ESG strategies in public hospitals. (Less)
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author
Abdulai, Sualihu Wunniche LU and Im, Yujin LU
supervisor
organization
alternative title
Integration of Environmental, social and Governance (ESG) frameworks within public hospital in Ghana, focusing on the institutional pressures influencing ESG adoption and their impact on professionals' daily operations.
course
SMMM40 20251
year
type
H2 - Master's Degree (Two Years)
subject
keywords
ESG (Environmental, Social, and Governance), institutional theory, institutional work, public hospitals, sustainability, Sustainable Development Goals (SDGs), Ghana
language
English
id
9209322
date added to LUP
2025-08-04 11:08:44
date last changed
2025-08-04 11:08:44
@misc{9209322,
  abstract     = {{This study explores the integration of Environmental, Social, and Governance (ESG) frameworks within public hospitals in Ghana, focusing on the institutional pressures influencing ESG adoption and their impact on healthcare professionals’ daily operations. It also considers the alignment of these practices with selected United Nations Sustainable Development Goals (SDGs). Addressing gaps in the literature—such as the dominance of high-income country perspectives, the limited voices of internal stakeholders, and overreliance on
quantitative methods—this research adopts a qualitative approach grounded in institutional theory. Drawing on semi-structured interviews with 14 clinical and non-clinical staff at two district public hospitals in Ghana, the study investigates how ESG principles are interpreted and enacted in under-resourced settings. The findings show that institutional pressures—coercive, normative, and mimetic—shape ESG adoption in uneven ways. Practices are often
informal, fragmented, and initiated by individuals rather than formal strategies. Environmental initiatives are most visible but lack strategic direction; social efforts face weak institutional support; and governance practices are hindered by leadership and accountability gaps. This
Research contributes to ESG discourse by situating sustainability within the lived experiences of LMIC healthcare professionals. It offers theoretical insight into how institutional pressures function in resource-limited environments and provides practical guidance for developing context-sensitive ESG strategies in public hospitals.}},
  author       = {{Abdulai, Sualihu Wunniche and Im, Yujin}},
  language     = {{eng}},
  note         = {{Student Paper}},
  title        = {{From Pressure to Practice: Institutional Pressures and ESG Adoption in LMIC Healthcare- A Case Study of Ghanaian Public Hospitals}},
  year         = {{2025}},
}